Hollow suture needle with handle

ABSTRACT

A suture needle instrument having improved connection means enabling a hollow suture needled to be attached to a handle in a variety of orientations. The suture needle is provided with user accessible suture channels and suture advancing wheels to facilitate cleaning and repair.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention relates to devices used for suturing tissue duringsurgical procedures. More particularly, the invention relates to devicesused to advance suture through tissue via a hollow needle piercing thetissue to be sutured. Still more particularly, the invention relates tosuturing devices for use during endoscopic surgical procedures.

2. Background of the Prior Art

Devices for facilitating the suturing of tissue during endoscopicsurgical procedures are commonly used. One such device is the Spectrum®tissue repair system made by Linvatec Corporation. The systemincorporates a suture hook handle adapted to receive a variety of suturehooks, i.e. hollow needles, each suture hook having a distal tip shapedin varying ways. The suture hook handle is provided with a pair ofopposed suture advancing wheels, the perimeters of which are coveredwith an elastomeric material. The wheels are aligned in a common planeand rotatable about their respective axes which are spaced apredetermined distance apart so that the perimeters of the wheels may beadjacent or contiguous to each other. The suture hook handle comprises apair of diametrically opposed suture passageways leading to the nip ofthe wheels so that a suture inserted into a selected passageway isguided to the nip of the wheels and by rotation of one of the wheels maybe advanced through the lumen of the selected needle.

The various suture hooks are attachable to the suture hook handle bymeans of an axially aligned recess at the distal end of the handle, therecess being adapted to receive a complementarily shaped hub attached tothe proximal end of each suture hook. The end wall of the recess has anaxially aligned aperture to receive suture from the nip of the wheelsand guide it to the needle lumen. Once a suture hook is assembled withthe suture hook handle, it is secured thereto by a transverse set screwwhich is advanced radially into the recess to engage a dimple on the hubof the suture hook to secure the hook to the handle.

While offering significant advantages and facilitating the suturing oftissue during endoscopic surgical procedures, the prior art device isnot easily disassembled for cleaning or repair and does not allowreorientation of the suture hook during a surgical procedure.Orientation of this prior art device is generally accomplished byinserting a different suture hook rather than simply reorienting the onecurrently in use. Accordingly, it is an object of this invention toproduce a suture hook system overcoming the disadvantages of the priorart device.

It is also an object of this invention to produce a suture hook handlewhich is easily disassembled for cleaning or repair.

It is also an object of this invention to produce a suture hook systemwhich enables the reorientation of a selected suture hook during asurgical procedure.

SUMMARY OF THE INVENTION

These and other objects of the invention are achieved by the embodimentsof the invention disclosed herein. In one aspect, the inventioncomprises a suture passer comprising a handle having an axis and a pathwithin the handle for guiding suture to a predetermined point. A hollowneedle is attachable to the handle and a user-operable wheel means ismounted on the handle for engaging the suture at the predetermined pointand moving it into the lumen of the hollow needle. The hollow needle hasa proximal hub which cooperates with a collet on the distal end of thehandle to produce a connector means interposed between the handle andthe needle for attaching them together in a selected one of a pluralityof predetermined rotational positions. The connector means comprises anextension member at the distal end of the handle, the extension having arecess and a collar axially aligned with and rotatably attached to theextension member. The collar has a proximal end and a distal end and isrotatable between an open position, in which it can receive the hollowneedle, and a closed position in which it can hold the hollow needle tothe handle. A hub is fixedly attached to the proximal end of the hollowneedle, the hub comprising a body adapted to be received in the recessand an axial bore within the body. The bore is aligned with the lumen ofthe hollow needle and the predetermined point when the needle isassembled with the handle. A locking means is adapted to be engaged bythe collar when it is in the closed position.

In another aspect, the aforementioned handle comprises a sagittal planarsurface within the handle. A pair of wheels is attached to the handle,each rotatable about its own axis, with the axes of the wheels parallelto each other, perpendicular to the sagittal plane and spaced apart apredetermined distance to enable the perimeters of the wheels to beadjacent to each other at a first point. At least one first suturepassageway is provided for guiding a suture from an aperture on thesurface of the handle to the predetermined point between the wheels. Thefirst suture passageway comprises a groove in the sagittal planarsurface, the groove extending between the aperture on the surface of thehandle and a second point adjacent and proximal to the first point.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front perspective view of a suture hook handle and suturehook constructed in accordance with the principles of this invention.

FIG. 2 is a top plan view of FIG. 1.

FIG. 3 is a right side elevational view of FIG. 1 showing the suturehook handle in an open position.

FIG. 4 is a view of FIG. 3 showing the suture hook handle in a lockedposition.

FIG. 5 is a front perspective exploded view showing the various parts ofthe invention in relation to each other.

FIG. 6 is a side elevational view of the suture hook system shown inFIG. 1 with a cover portion removed from the handle.

FIG. 7 is a cross-sectional view of FIG. 2 taken along the lines 7-7.

FIG. 8 a is a side elevational view of a suture hook for use with thesuture hook handle shown in FIG. 1.

FIG. 8 b is a top plan view of FIG. 8 a.

FIG. 8 c is a left end view of FIG. 8 a.

FIG. 8 d is a left side perspective view of FIG. 8 a.

FIG. 9 a is a side elevational view of a suture hook for use with thesuture hook handle shown in FIG. 1.

FIG. 9 b is a top plan view of FIG. 9 a.

FIG. 9 c is a left end view of FIG. 9 a.

FIG. 9 d is a left side perspective view of FIG. 9 a.

FIG. 10 a is a side elevational view of a suture hook for use with thesuture hook handle shown in FIG. 1.

FIG. 10 b is a top plan view of FIG. 10 a.

FIG. 10 c is a left end view of FIG. 10 a.

FIG. 10 d is a left side perspective view of FIG. 10 a.

BRIEF DESCRIPTION OF THE PREFERRED EMBODIMENT

The suture hook system 10 as shown in the drawings comprises handle 12and suture hook 14. It will be understood that suture hook 14 may beprovided in a variety of lengths, diameters and needle curves. Handle 12is provided near its distal end with a pair of rotatable wheels 16 and18 which are mounted with their axes 20 and 22 parallel to each otherand spaced apart symmetrically about the handle axis 24. The wheels eachhave a perimeter which may be covered with a polymeric or otherwisefriction enhancing surface 26. The surface 26 may be ribbed or smooth,or may have a central smooth band portion bounded by ribbed bandportions. The wheels are mounted in such a way that their perimetralsurfaces contact each other at the nip 28 of the wheels. In thepreferred embodiment nip 28 lies on axis 24. As will be understoodbelow, rotation of either one of the wheels 16, 17 will cause rotationof the other wheel and will cause suture 27 (situated between thewheels) to be urged along suture path 29.

Handle 12 is provided near its distal end 15 with a collar 30 which isadapted to rotate within a limited range about axis 24 in order to locksuture hook 14 to handle 12 as will be understood below.

Collar 30 has a transverse distal end wall 32 in the form of a radiallyinwardly extending flange defining a circular aperture 34 concentricallyaligned about axis 24. Aperture 34 is further provided with a pair ofdiametrically opposed keyways 36, 38. As will be explained below,keyways 36 and 38 facilitate the engagement of suture hook 14 withhandle 12.

As will be noted in FIG. 5, collar 30 is situated over a distalextension member 40 situated at the distal end 15 of handle 12.Extension 40 has a cylindrical external surface 41 and defines a recess42 for receiving a proximal portion of the suture hook 14 as will beexplained below. Extension 40 further comprises a pair of diametricallyopposed throughbores 44 (only one of which is shown in FIG. 5), eachthroughbore adapted to receive a guide pin 46 which extends through thewall of the extension 40 and partially into recess 42 (as best seen inFIG. 7). Extension 40 is also provided on its exterior surface with adiametrically opposed pair of cam tracks 50 (only one of which is shownin FIG. 5) which are slightly helically situated about axis 24. Whencollar 30 is assembled with handle 12, its peripheral wall 52 will coverextension 40 and collar 30 will be rotatably attached to the handle viadiametrically opposed pins 54 (only one of which is shown in FIG. 5)which extend through wall 52 and into cam track 50. It will beunderstood that the two ends of cam tracks 50 serve to limit therotation of collar 30 about axis 24 by virtue of the abutment of pins 54against the ends of the cam tracks 50.

Suture hook 14 has a distal end 60 and a proximal end 62. Distal end 60is provided with a conventional hollow needle 64 having a predeterminedshape. It will be understood that the suture hook system may be producedwith suture hooks having a variety of distal tip shapes. Proximal end 62of suture hook 14 is provided with a hub 66 comprising a body 68 of agiven diameter and a transverse locking bar 70 of a greater diameter.The suture hook 14 may comprise a pair of concentric tubes as shown inFIG. 7, the outer tube serving as reinforcement for the inner tube whichdefines the actual lumen and needle tip. Body 68 is provided with a pairof diametrically opposed and longitudinally extending channels 72 (bestseen in FIGS. 8 c and 8 d). Transverse bar 70 is fixedly secured to thedistal-most end of body 68 and facilitates the engagement of suture hook14 to handle 12.

The method of attachment of suture hook 14 to handle 12 is bestunderstood by reference to FIGS. 3 and 4. Prior to assembly of suturehook 14 with handle 12, the collar 30 is placed in an open or unlockedposition as shown in FIG. 3. This enables aperture 34 to receive body 68and further enables keyways 36 and 38 to receive transverse bar 70. Asbody 68 is moved further proximally into recess 42, the distal mostsurface 76 of transverse bar 70 will be situated proximal to theproximal side of flange 32 of collar 30. To accomplish this of coursesuture hook 14 must be rotated about axis 24 to align transverse lockingbar 70 with keyways 36 and 38 while also aligning longitudinal grooves72 with guide pins 46. When suture hook 14 is properly seated, collar 30may be rotated from its open position shown in FIG. 3 to its lockedposition shown in FIG. 4, thereby retaining transverse bar 70 behindflange 32 and securing suture hook 14 to handle 12. As collar 30 isrotated from the open to the locked position, locking pins 54 slidewithin their respective grooves 50 to urge collar 30 slightly proximallyto enhance the force with which flange 32 presses against the opposingends of transverse bar 70. The degree of force thus exerted by collar 30on transverse bar 70 may be varied by changing the pitch of the helicaltracks 50. It will be further understood that the ends of the tracksnear the locked position of collar 30 may be transverse rather thanhelical or may be provided with some other shape in order to securelylock collar 30 in place.

It will be understood that suture hook 14 may be easily repositioned toa different rotational position during a surgical procedure bymomentarily disengaging it from handle 12, rotating it 180° about axis24 and reattaching it.

Referring now to FIGS. 1, 2 and 6 it is noted that handle 12 is providedwith a removable cover 80 which comprises a portion of the outer surfaceof handle 12. The purpose of cover 80 is to enable handle 12 to have anergonomically favorable external shape while also enabling handle 12 tobe structured internally in such a way as to facilitate cleaning andrepair of handle 12.

As best seen in FIG. 6, handle 12 is provided with a sagittal planarsurface 82 aligned along axis 24 and extending transversely across thebody of handle 12. In the preferred embodiment, handle 12 is furtherprovided with a pair of recesses 84 and 86 which are adapted to receivewheels 16 and 18, respectively. (Alternatively, one recess could beadapted to retain both wheels.) Each wheel has an axis pin 88 whichextends a predetermined distance transversely along the axis 20 of eachwheel. Accordingly, recesses 84 and 86 are each provided with a centralbore 89 for receiving axis pins 88 of each wheel. As best seen in FIG.2, the bores 89 for receiving axis pins 88 extend into the body ofhandle 12 and into the cover 80. It will be understood that the depthsof recesses 84 and 86 are preferably such as to receive one half thethickness of wheels 16 and 18. Symmetrical recesses are formed in cover80 in order to enable wheels 16 and 18 to be aligned with axis 24 asbest seen in FIGS. 2, 3 and 4.

Sagittal planar surface 82 is also provided with a pair of sutureguiding channels 90 and 92 which extend between diametrically opposedopenings 94 and 96 on the surface of handle 12 and a point adjacent andproximal to the nip 28 of the wheels 16 and 18. While a pair of sutureguiding channels is provided in the preferred embodiment, this is toenable both right and left handed use of the device. Alternatively, onlyone channel may be provided. Sagittal planar surface 82 may also beprovided with a channel 98 extending between a point adjacent to anddistal to the nip 28 of the wheels and the proximal side of recess 42.It will be noted that the inside surface of cover 80, that is thesurface which lies against saggital planar surface 82 when cover 80 isassembled with handle 12, need only be provided with recesses to receiveaxis pins 88. In the preferred embodiment, however, the cover is alsoprovided with recesses 100 adapted to receive those sides of the wheelswhich are not received within recesses 84 and 86. That is, insidesurface of cover 12 need not be provided with any grooves for guidingsuture. It will be sufficient if grooves 90 and 92 are sufficientlylarge to accept the desired size suture. Alternatively, of course,passageways 90 and 92 may be formed by symmetrical and cooperatingsemi-circular grooves formed in sagittal planar surface 82 and theinside surface of cover 80. Additionally, while openings 94 and 96 areshown to be on the side of the handle, it will be understood that asingle opening could be provided at the back of the handle so that thechannel leading the suture to the nip of the rollers could be coaxial.The path followed by the suture is sometimes referred to herein assuture path 29.

The suture hook 14 shown in FIGS. 1 through 7 is shown in greater detailin FIGS. 8 a through 8 d. As noted, body 68 of suture hook 14 comprisesa pair of diametrically opposed grooves 72. An alternative embodiment ofa suture hook is shown in FIGS. 9 a through 9 d as suture hook 114 whichcomprises four straight and equiangularly spaced longitudinal grooves172, thus enabling four discrete orientations of suture hook 114 aboutaxis 24. Further embodiment of a suture hook is shown in FIGS. 10 athrough 10 d as suture hook 214 having four equiangularly spacedlongitudinal grooves 272, each of which is provided with a J-hook at itsdistal-most end to enable the suture hook to be locked to a suture hookhandle without the need for a collar such as collar 30.

The proximal hubs of each of the suture hook embodiments are shown witha cylindrical configuration, the axis of body 68 being aligned with axis24. It will be understood that body 68 may be made rectilinear so thatits cross-section (transverse to axis 24) could be polygonal.

While collar 30 and its operation with locking tab 70 have been shown asa rotary embodiment, it will be understood that the invention could beredesigned as a linear embodiment in which the opening and closing of alocking mechanism could be effected by moving a collar longitudinallyalong the handle axis. For example, a quick lock mechanism could be usedwith a collar cam arrangement moving a plurality of circumferentiallyspaced fingers into and out of engagement with a groove on the hub ofthe needle.

Wheels 16 and 18 have been described as having their perimetral surfacesin contact with each other. It will be understood that the degree ofcontact is dependent upon the softness of the perimeter surface and thesize of suture to be advanced. In some instances, contact may beunnecessary if the suture is large enough and the surface is able to“grip” the suture enough to advance it as one or both wheels roll. Thus,it is sufficient for the wheel perimeters to be adjacent to each other,it being understood that the term “adjacent” may require contact so thesuture may be squeezed sufficiently to be advanced.

It will be understood that numerous other modifications and improvementsmay be made to the preferred embodiment of the invention disclosedherein without departing from the spirit and scope thereof.

1-15. (canceled)
 16. A surgical instrument comprising: a hollow needlehaving an axial lumen; a handle having a proximal end and a distal end,said distal end adapted to selectively receive and retain said hollowneedle, said handle defining a sagittal planar surface within saidhandle, said lumen in said hollow needle being aligned with said surfacewhen said needle is retained by said handle; a pair of suture-advancingwheels attached to said handle, each rotatable about an axis, and therotational axes of said wheels being parallel to each other,perpendicular to said sagittal plane, and spaced apart a predetermineddistance to enable the perimeters of said wheels to be closelyjuxtaposed to or contact one another, such that a nip is defined at afirst point between said wheels; at least one first suture passagewayfor guiding a suture from an aperture on the surface of said handle tosaid nip, said first suture passageway comprising a groove formed insaid sagittal planar surface and extending between said aperture on thesurface of said handle and a second point adjacent and proximal to saidfirst point; and a cover adapted to be removed from and attached to saidhandle, said cover defining an internal complementary planar surfaceadapted to be juxtaposed to said sagittal planar surface, whereby whensaid cover is attached to said handle, said complementary planar surfaceconfines a suture in said groove in said sagittal planar surface,thereby completing said suture passageway.
 17. A surgical instrumentaccording to claim 16, further comprising: a second suture passagewaygenerally in line with said first suture passageway, said second suturepassageway for guiding a suture from said nip between said wheels tosaid lumen of said hollow needle, said second suture passagewaycomprising a second groove formed in said sagittal planar surfaceextending between a third point adjacent said wheels and a fourth pointadjacent the lumen of said needle when retained.
 18. A surgicalinstrument according to claim 16, further comprising a wheel recessformed in said sagittal planar surface for receiving a portion of theouter perimeter of each of said wheels.
 19. A surgical instrumentaccording to claim 18 wherein each wheel is received within its ownrecess and wherein the recesses associated with each wheel are disposedopposite one another on either side of said nip defined between saidwheels.
 20. A surgical instrument according to claim 19 furthercomprising a further bore formed in said wheel recess for receivingtherein an axis pin of each wheel.
 21. A surgical instrument accordingto claim 19 wherein each wheel recess is deep enough to receive thereinone half of the thickness of the wheel to be received in the recess andwherein said cover defines complementary recesses for receiving theremaining thickness of the wheels, confining the wheels between saidsagittal surface and said cover.
 22. A surgical instrument according toclaim 16, wherein said first groove in said sagittal planar surfaceforms approximately one-half of the cross-section of said first suturepassageway and wherein a mating second groove is formed in saidcomplementary planar surface of said cover, said second groove formingapproximately one-half of the cross-section of said first suturepassageway, such that when said cover is assembled to said handle saidsecond groove formed in the cover is positioned adjacent said firstgroove in the handle, whereby said first suture passageway is defined bysaid adjacent grooves.
 23. A surgical instrument according to claim 22wherein the outer surface of said cover conforms to the adjacent surfaceof said handle.